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Acute pain relief for migraine: Pros and cons
By Mayo Clinic staffAcute treatment can help you stop a migraine at the first sign of an impending attack. This type of treatment can ease accompanying symptoms — such as nausea and vomiting — as well.
If you have occasional migraines, acute treatment may help you minimize the amount of medication you take. This may be especially appealing if you're concerned about medication side effects.
But there are drawbacks to acute treatment, too. If you have frequent migraines, you may find yourself taking more medication than the label instructs or your doctor prescribes. You may not even realize that you've been dosing yourself too often until you miss a day and your head starts to hurt again — sometimes more intensely than before.
If you have medication overuse headaches, also known as rebound headaches, your body has become dependent upon your medication — just like habitual coffee drinkers become dependent on caffeine. When you suddenly stop, a headache results. To prevent rebound headaches, take acute medications no more than 10 times a month.
| Acute medication | Pros | Cons |
|---|---|---|
| Over-the-counter analgesics | Available without a prescription; NSAIDs helpful for migraines triggered by menstruation | May cause stomach upset or liver problems; if overused, may contribute to rebound headaches |
| Triptans | Nonsedating; relieve associated symptoms, such as nausea and sensitivity to light and sound; one brand available in injectable form and two brands available in nasal-spray form | Rarely, may cause heart attack or stroke; serotonin syndrome possible in connection with antidepressant use; cost per dose high, ranging from $19 wholesale for tablet to $73 wholesale for injectable |
| Ergots | Can help treat prolonged headaches; dihydroergotamine form available as a nasal spray | More likely to cause side effects |
| Butalbital combinations | May be an option when a less problematic drug can't be used or isn't effective | Habit-forming; likely to contribute to rebound headaches |
| Opiates | May provide potent pain relief | Habit-forming; likely to contribute to rebound headaches |
| Corticosteroids | May provide short-term relief when other treatments fail | Serious side effects possible from prolonged use |
